Adneksiyal kitlelerin benign malign ayrımında malignansi riski endeksine diğer parametrelerin katkısı
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Dosyalar
Tarih
2013
Yazarlar
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızın amacı adneksial kitlelerin benign malign ayrımının preoperatif dönemde yapılmasında Malignansi Riski Endeksi, yaş, trombosit, Renkli Doppler Ultrasonografi parametrelerinin etkinliklerinin araştırılmasıdır. Çalışmaya Trakya Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Ana Bilim Dalı Kliniğinde adneksiyal kitle tanısıyla opere edilen 155 olgu dahil edildi. Çalışma prospektif olarak yapıldı. Olgular preoperatif dönemde ultrasonografi, menapoz durumu ve serum Cancer Antigen 125 parametrelerinden oluşan Malignansi Riski Endeksi ve yaş, trombosit, Renkli Doppler Ultrasonografi parametreleri ile değerlendirildi. Olguların postoperatif histopatolojik tanıları, preoperatif dönemde değerlendirilen bu parametreler ile karşılaştırıldı. Çalışmaya alınan olguların yaşları 17 ile 76 arasında değişmekte idi. Malign olgularda yaş ortalaması 53,21; benign olgularda ise 45,47 idi. Olguların 92'si (% 59,3) premenopozal, 63'ü ise (% 40,6) postmenopozal idi. Premenopozal olguların 80?inde (% 86,9) adneksiyal kitlenin benign, 12'sinde (% 13,04) malign olduğu görüldü. Postmenopozal olguların 42'si (% 66,6) benign, 49'u (% 33,3) ise malign bulundu. Benign adneksiyal kitlesi olan olguların % 86,8'inde serum kanser antijen 125 değeri <35 U/ml iken, malign olguların % 72,7'sinde ise 35 U/ml'nin üzerinde saptandı. Malignansi Riski Endeksi ile incelemenin spesifitesi % 98,4 olarak; sensitivitesi % 75,8 olarak saptandı. Pozitif prediktif değer % 92,6 negatif prediktif değer ise % 93,8 olarak bulundu. Histopatoloji sonuçlarına göre olguların % 21,3'ünde malignite görülürken; trombosit değerine göre ise olguların % 16,8'inde malignite düşünüldü. Histopatolojide malign tanısı konulan 33 (% 21,3) olgudan 24'ünde (% 15,5) trombosit yüksekliği saptandı. Trombosit ile değerlendirmenin spesifitesi % 98,4, sensitivite % 72,7 idi. Pozitif prediktif değerin % 92,26 ve negatif prediktif değerin ise % 93,02 olduğu görüldü. Renkli Doppler Ultrasonografi sonuçları değerlendirmeye alınan; patolojide malign tanısı konulan 122 (% 78,7) olgunun 122?sinde (% 78,7) aynı sekilde malignite düşünüldü; diğer olgular Renkli Doppler Ultrasonografi ile benign olarak saptanmış olduğundan testin duyarlılığı % 100 olarak, özgüllüğü % 100 olarak saptandı. Sonuç olarak, adneksiyal kitlelerde malignansi riski endeksi ile birlikte, Renkli Doppler Ultrasonografi, yaş ve trombosit sayısı da değerlendirildiğinde benign malign ayrımı daha efektif olmaktadır. Anahtar kelimeler: Malignansi Riski Endeksi, Renkli Doppler Ultrasonografi, adneksiyal kitle, over kanseri, trombosit
Abstract
The aim of this study was to investigate preoperatively the effectivities of The Risk of Malignancy Index, age, platelet, Color Doppler Ultrasound parameters in the differentiation of adnexal masses are malign or benign. 155 patients operated with the diagnosis of adnexal masses in Trakya University Faculty of Medicine, Department of Obstetrics and Gynecology were included in the study. A prospective study was performed. The patients in the preoperative period were assessed by age, platelets, Color Doppler Ultrasound and The Risk of Malignancy Index consisting parameters of Ultrasonography, menopausal status and serum cancer antigen 125. Postoperative histopathological diagnoses were compared with those parameters evaluated preoperatively. Ages of the patients ranged from 17 to 76. The mean age of malign cases was 53.21; and in benign cases was 45.47. 92 patients (% 59.3) were premenopausal women, while 63 patients(% 40.6) were postmenopausal. Among the premenopausal patients, adnexal masses were found to be benign in 80 patients (% 86.9) and malign in 12 patients (% 13.04). % 86.8 of patients with benign adnexal mass detected in the value of serum cancer antigen 125 <35 U / ml while % 72.7 of patients with malignancy detected in >35 U / mL, respectively. The risk of Malignancy Index examination was found to have % 98.4 specificity, and % 75.8 sensitivity, respectively. Positive predictive value was found to be % 92.6, negative predictive value was % 93.8. While according to the results of histopathology % 21.3 of the patients were malign; % 16.8 of the cases according to the value of platelet were thought to be malignant. Platelet elevation was observed in 24 patients (% 15.5) of 33 (% 21.3) patients with histopathologically diagnosed as malignant. Specificity of assesment of platelet counting was % 98.4, the sensitivity was % 72.7. Positive predictive value was % 92.26 and negative predictive value was % 93.02. In the evaluation results of Color Doppler Ultrasonography; 122 (% 78.7) patients of 122 (% 78.7) patients diagnosed pathologically as malignant were thought to have malignancy in the same way because of other cases were determined as benign in Color Doppler Ultrasonography; test sensitivity was % 100, and the specificity was % 100. As a result, if adnexal masses were evaluated by The Risk of Malignancy Index, Color Doppler Ultrasonography, age and platelet count, it will be a more effective differentation of benign and malignant. Key words: The Risk of Malignancy Index, Color Doppler Ultrasonography, adnexal mass, ovarian cancer, platelet
Abstract
The aim of this study was to investigate preoperatively the effectivities of The Risk of Malignancy Index, age, platelet, Color Doppler Ultrasound parameters in the differentiation of adnexal masses are malign or benign. 155 patients operated with the diagnosis of adnexal masses in Trakya University Faculty of Medicine, Department of Obstetrics and Gynecology were included in the study. A prospective study was performed. The patients in the preoperative period were assessed by age, platelets, Color Doppler Ultrasound and The Risk of Malignancy Index consisting parameters of Ultrasonography, menopausal status and serum cancer antigen 125. Postoperative histopathological diagnoses were compared with those parameters evaluated preoperatively. Ages of the patients ranged from 17 to 76. The mean age of malign cases was 53.21; and in benign cases was 45.47. 92 patients (% 59.3) were premenopausal women, while 63 patients(% 40.6) were postmenopausal. Among the premenopausal patients, adnexal masses were found to be benign in 80 patients (% 86.9) and malign in 12 patients (% 13.04). % 86.8 of patients with benign adnexal mass detected in the value of serum cancer antigen 125 <35 U / ml while % 72.7 of patients with malignancy detected in >35 U / mL, respectively. The risk of Malignancy Index examination was found to have % 98.4 specificity, and % 75.8 sensitivity, respectively. Positive predictive value was found to be % 92.6, negative predictive value was % 93.8. While according to the results of histopathology % 21.3 of the patients were malign; % 16.8 of the cases according to the value of platelet were thought to be malignant. Platelet elevation was observed in 24 patients (% 15.5) of 33 (% 21.3) patients with histopathologically diagnosed as malignant. Specificity of assesment of platelet counting was % 98.4, the sensitivity was % 72.7. Positive predictive value was % 92.26 and negative predictive value was % 93.02. In the evaluation results of Color Doppler Ultrasonography; 122 (% 78.7) patients of 122 (% 78.7) patients diagnosed pathologically as malignant were thought to have malignancy in the same way because of other cases were determined as benign in Color Doppler Ultrasonography; test sensitivity was % 100, and the specificity was % 100. As a result, if adnexal masses were evaluated by The Risk of Malignancy Index, Color Doppler Ultrasonography, age and platelet count, it will be a more effective differentation of benign and malignant. Key words: The Risk of Malignancy Index, Color Doppler Ultrasonography, adnexal mass, ovarian cancer, platelet
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Malignansi Riski Endeksi, Renkli Doppler Ultrasonografi, Adneksiyal Kitle, Over Kanseri, Trombosit, The Risk of Malignancy Index, Color Doppler Ultrasonography, Adnexal Mass, Ovarian Cancer, Platelet
